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Single-level vertebral kyphoplasty is not associated with an increased risk of symptomatic secondary adjacent osteoporotic vertebral compression fractures: a matched case–control analysis

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Abstract

Summary

This matched case–control study compared the rate of symptomatic adjacent-level vertebral compression fractures (VCF) within 1 year in patients operatively treated with kyphoplasty to a control group of non-operatively treated VCFs. The adjacent-level fracture rate did not show a significant difference between groups.

Purpose

To compare the rate of new symptomatic adjacent-level fractures within 1 year after an isolated osteoporotic vertebral compression fracture (VCF) treated by either kyphoplasty or non-operative treatment.

Methods

Patients aged ≥ 50 years with an isolated, fresh, and symptomatic osteoporotic VCF who were treated by kyphoplasty were compared to patients of similar age, gender, vertebral segment, and bone mineral density who were treated non-operatively (n = 98). A matched case–control analysis was conducted by retrospective chart review, and the rate of new adjacent-level symptomatic vertebral fractures, defined as occurring within two segments of the index fracture, within the first year was determined.

Results

Ninety-eight patients (66 female, aged 73.5, SD 9.7 years) were analyzed in this matched case–control study. The adjacent fracture rate within 1 year was not different between the kyphoplasty group and the non-operative group (20.4 vs 18.4%; McNemar, p = 1.0). The time to a new adjacent fracture after the index fracture was significantly shorter in the kyphoplasty (7, SD 8 weeks) versus non-operative group (22, SD 13 weeks).

Conclusions

Patients with osteoporotic VCFs treated with kyphoplasty did not show an increased rate of additional symptomatic adjacent-level VCFs when compared to a non-operative control group matched for age, gender, fracture level, and bone mineral density.

Level of Evidence: Level III.

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Authors and Affiliations

  1. Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Henrik Teuber, Simon Tiziani, Sascha Halvachizadeh, Kai Sprengel, Hans-Christoph Pape & Georg Osterhoff

  2. Department of Rheumatology, University Hospital Zurich, Zürich, Switzerland

    Diana Frey

Authors
  1. Henrik Teuber
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  2. Simon Tiziani
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  3. Sascha Halvachizadeh
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  4. Diana Frey
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  5. Kai Sprengel
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  6. Hans-Christoph Pape
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  7. Georg Osterhoff
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Corresponding author

Correspondence to Georg Osterhoff.

Ethics declarations

The study was approved by the local ethics committee (Kantonale Ethik-Kommission Zürich, KEK-ZH-Nr. 2017-00408).

Conflicts of interest

Georg Osterhoff has given paid lectures for Medtronic, Stryker, and Stöckli Medical, all three being manufacturers or distributors of kyphoplasty systems. Henrik Teuber, Simon Tiziani, Sascha Halvachizadeh, Diana Frey, Kai Sprengel, and Hans-Christoph Pape declare that they have no conflict of interest.

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Teuber, H., Tiziani, S., Halvachizadeh, S. et al. Single-level vertebral kyphoplasty is not associated with an increased risk of symptomatic secondary adjacent osteoporotic vertebral compression fractures: a matched case–control analysis. Arch Osteoporos 13, 82 (2018). https://doi.org/10.1007/s11657-018-0489-6

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  • DOI: https://doi.org/10.1007/s11657-018-0489-6

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